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Resumen Introducción: La biodiversidad se está perdiendo a un ritmo acelerado como resultado del cambio global. Herramientas como los modelos de distribución de especies (MDEs) han sido ampliamente usados para mejorar el conocimiento sobre el estado de conservación de las especies y ayudar a desarrollar estrategias de gestión para mitigar la pérdida de biodiversidad. Objetivo: Determinar cómo la distribución potencial predicha por los MDEs para ocho especies de murciélagos amenazados difiere de los mapas de distribución reportados por la UICN. También, inferir el área de distribución y estado de endemismo de cada especie, y evaluar la importancia de la región tumbesina para su conservación. Métodos: Basados en registros de presencia del rango global de las especies, usamos MDEs para evaluar el estado de conservación de estas ocho especies en la región tumbesina de Ecuador y Perú. Resultados: Las áreas estimadas por los MDEs eran 35-78 % más pequeñas para cuatro especies (Eptesicus innoxius, Lophostoma occidentale, Platalina genovensium y Lonchophylla hesperia) y 26-1 600 % más grandes para tres especies (Amorphochilus schnablii, Promops davisoni y Rhogeessa velilla) que aquellas reportadas por la UICN. Para Tomopeas ravus, el área estimada por el MDE y la UICN fue similar, pero difirió en la distribución espacial. Los MDEs coincidieron con áreas de endemismo informadas por autores previos para E. innoxius, R. velilla y T. ravus, pero fueron diferentes para A. schnablii, P. genovensium, P. davisoni y L. hesperia, debido en parte a las distribuciones proyectadas para estas últimas especies en valles secos interandinos según los MDEs. Conclusiones: La región tumbesina representa una porción significativa (40-96 %) de la distribución predicha de siete de las ocho especies estudiadas, subrayando la importancia de esta región para la conservación de murciélagos. Nuestros resultados muestran las probables distribuciones para estas especies y proporcionan una base importante para identificar vacíos de investigación y desarrollar medidas de conservación para murciélagos amenazados en el punto caliente de biodiversidad de Tumbes.

Abstract Introduction: Biodiversity is being lost at an accelerating rate because of global change. Tools such as species distribution models (SDMs) have been widely used to improve knowledge about species' conservation status and help develop management strategies to mitigate biodiversity loss. SDMs are especially important for species with restricted distributions, such as endemic species. Objective: To determine how potential distribution predicted by SDMs for eight threatened bat species differed from the distribution maps reported by the IUCN. Also, to infer the area of distribution and state of endemism of each specie, and to evaluate the importance of the Tumbesian region for their conservation. Methods: Based on presence records across the species' entire ranges, we used SDMs to assess the conservation status of these eight species in the Tumbesian region of Ecuador and Peru. Results: The areas estimated by SDMs were 35-78 % smaller for four species (Eptesicus innoxius, Lophostoma occidentale, Platalina genovensium and Lonchophylla hesperia) and 26-1 600 % larger for three species (Amorphochilus schnablii, Promops davisoni and Rhogeessa velilla) than those reported by the IUCN. For Tomopeas ravus, the area estimated by the SDM and IUCN was similar but differed in spatial distribution. SDMs coincided with areas of endemism reported by previous authors for E. innoxius, R. velilla, and T. ravus, but were different for A. schnablii, P. genovensium, P. davisoni, and L. hesperia, due in part to projected distributions for these latter species in dry inter-Andean valleys according to the SDMs. Conclusions: The Tumbesian region represents a significant portion (40-96 %) of the predicted distribution of seven of the eight species studied, underscoring the importance of this region for bat conservation. Our results show likely distributions for these species and provide an important basis for identifying research gaps and developing conservation measures for threatened bats in the Tumbes biodiversity hotspot.

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INTRODUCTION:  Renal cell carcinoma (RCC) is one of the most common types of kidney cancer. While RCC tends to present as a localized tumor, a notable proportion may present with distant metastasis. In some instances, RCC may also present with intravascular tumor extension, often called tumor thrombus (TT). Its presence confers a worse prognosis and has important implications for the tumor's staging and treatment. Despite extensive documentation of RCC TT in the US, limited data exists regarding its presentation, management, and outcomes in Puerto Rico (PR). This study aims to broaden the available information on RCC TT, emphasizing surgical management and outcomes. We also provide descriptive data on patient demographics and clinical presentation to improve decision-making among clinicians caring for Puerto Rican men and women. METHODS:  In this single-center, retrospective study, we evaluated patients who underwent partial or total nephrectomy at Saint Luke's Episcopal Medical Center between 2018 and 2022. Data was abstracted from electronic health records (EHR). Patients without documented evidence of TT during the peri-operative period were excluded from the study. A total of 220 patient records were evaluated, of which 12 met the inclusion criteria for the study. Cases were categorized using the latest RCC TT guidelines. Central tendency measurements were used to describe the sample distribution. The mean was considered to make assumptions regarding the prevalent observations, and the median was considered to rule out possible outliers. Categorical data were evaluated using proportion analyses, including TT extension level and BMI variables. Fisher's exact test evaluated the association between the World Health Organization/International Society of Urological Pathology (WHO/ISUP) grade and TT extension level. RESULTS:  Most patients lacked TT-related symptoms. The most severe presenting symptom was a pulmonary embolism (8.3%). Hypertension (83.3%), BMI greater than 25 at the time of diagnosis (75%), and type 2 diabetes mellitus (66.7%) were the most common comorbid conditions within our cohort. Nearly 75% of patients underwent laparoscopic radical nephrectomy with TT resection. One left-sided level III case was managed by laparoscopic-assisted open radical nephrectomy with a right subcostal incision. There were zero intraoperative complications and two postoperative complications. The histopathological reports of all cases were consistent with clear cell carcinoma, and half of the cases (n=6) were WHO/ISUP G4. All patients are alive and free of disease. CONCLUSION:  RCC is a common renal neoplasm in PR that can present with intravascular tumor extension. Our findings do not establish a definitive association between BMI, tumor size, WHO/ISUP grading, and TT extension level. Our study shows that laparoscopic removal of RCC TT is a safe and effective approach. However, the generalizability of our findings is limited by the study's design and sample size. Future research should focus on identifying predictive markers, establishing effective screening protocols, and determining if our hybrid approach has comparable outcomes to the standard open approach.

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BACKGROUND: Despite the increasing recognition of PD-L1 as predictor of immunotherapeutic response in various malignancies, its role and prognostic significance in thyroid cancer remain underexplored and subject to debate. This study begins to address this gap by comprehensively analyzing PD-L1 expression in papillary thyroid carcinoma (PTC) and investigating its correlation with key clinicopathological variables. METHODS: We conducted immunohistochemistry (IHC) to assess PD-L1 expression in whole-tissue sections from 121 primary papillary thyroid carcinoma (PTC) cases. We then analyzed the correlations between PD-L1 expression and various clinicopathological variables. RESULTS: PD-L1 expression was detected in 33.1% of papillary thyroid carcinomas (PTCs), predominantly exhibiting weak to moderate intensity. Notably, this study found no significant correlation between PD-L1 expression and various clinicopathological variables. The lack of association with traditional factors such as age, sex, histological subtype, and tumor size suggests the complex and multifaceted nature of PD-L1 regulation in PTC. Multivariate logistic regression analysis identified chronic lymphocytic thyroiditis with oncocytic metaplasia as the sole independent predictor of PD-L1 expression (P = 0.014), underlining the potential influence of the tumor microenvironment on immune checkpoint expression in PTC. CONCLUSIONS: Our study underscores the intricate interplay between chronic lymphocytic thyroiditis with oncocytic metaplasia and PD-L1 expression in papillary thyroid carcinoma. The observed link suggests a potential avenue for therapeutic intervention using anti-PD-1/PD-L1 therapies in surgery-refractory PTC. Understanding the dynamics of immune checkpoint regulation in the context of the tumor microenvironment is crucial for devising effective treatment strategies. Future research endeavors should delve deeper into the molecular mechanisms underlying this interaction and explore its implications for patient outcomes. As the field of immunotherapy continues to evolve, our findings contribute valuable insights into the complex immunological landscape of thyroid cancer.

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Background Ulnarly sided wrist pain is a common and challenging symptom. Arthroscopy has become a safe and effective tool for the correct diagnosis and treatment, proving to be better than all other clinical and imaging diagnostic methods. Some tests have been described for the diagnosis of triangular fibrocartilage (TFC) lesions, such as the trampoline test for peripheral lesions and the hook, ghost, and suction tests for foveal detachments. In tears at the disc level, when they affect all layers of the TFC (complete lesion) at the same point, testing with the probe will usually suffice for the diagnosis. However, in some apparently partial lesions, the probe cannot pass through all layers because the proximal and distal sites of the lesion are not aligned. There has been no arthroscopic test described for such cases. Case Description We describe a simple and practical test that we have called the "bubble test" in a typical case to diagnose TFC central injuries, aiming to discriminate partial from complete lesions, which are eventually hard to differentiate through direct vision and arthroscopic probing, leading to a direct influence onto the treatment. The bubble test is performed with external compression of the distal radioulnar joint (DRUJ) aspect, with the thumb on the back of the DRUJ and the index and middle fingers onto the volar aspect. The abrupt compression of this region causes the passage of air mixed with synovial fluid from the DRUJ to the radiocarpal joint, generating bubble formation. Clinical Relevance The bubble test should correlate to physical examination and imaging (magnetic resonance imaging [MRI]) findings and is particularly useful in central and degenerative (Type II) TFC lesions in patients complaining of chronic pain on the ulnar region of the wrist, with no history of trauma and with inconclusive MRI findings. Once the diagnosis is confirmed, arthroscopic treatment consists of wide debridement of the lesion with resection of the injured tissue and the local inflammatory reaction. Thus, it is essential for the correct treatment to define the exact location of the lesion and to know whether the disc injury is complete.

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BACKGROUND: Guide catheter extensions (GCEs) increase support and facilitate equipment delivery, but aggressive instrumentation may be associated with a higher risk of complications. AIM: Our aim was to assess the impact of GCEs on procedural success and complications in patients submitted to chronic total occlusion (CTO) percutaneous coronary intervention (PCI). METHODS: We analyzed data from the multicenter LATAM CTO Registry. Procedural success was defined as <30% residual stenosis and TIMI 3 distal flow. Major adverse cardiac and cerebrovascular events (MACCE) was defined as the composite of all-cause death, myocardial infarction, target vessel revascularization, and stroke. Propensity score matching (PSM) was used to compare outcomes with and without GCE use. RESULTS: From August 2010 to August 2021, 3049 patients were included. GCEs were used in 438 patients (14.5%). In unadjusted analysis, patients in the GCE group were older and had more comorbidities. The median J-CTO score and its components were higher in the GCE group. After PSM, procedural success was higher with GCE use (87.7% vs. 80.5%, p = 0.007). The incidence of coronary perforation (odds ratio [OR]: 1.46, 95% confidence interval [CI]: 0.78-2.71, p = 0.230), bleeding (OR: 1.99, 95% CI: 0.41-2.41, p = 0.986), in-hospital death (OR: 1.39, 95% CI: 0.54-3.62, p = 0.495) and MACCE (OR: 1.07, 95% CI: 0.52-2.19, p = 0.850) were similar in both groups. CONCLUSION: In a contemporary, multicenter cohort of patients undergoing CTO PCI, GCEs were used in older patients, with more comorbidities and complex anatomy. After PSM, GCE use was associated with higher procedural success, and similar incidence of adverse outcomes.

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Resumen Austrocylindropuntia pachypus (K.Schum.) Backeb. es un cactus endémico de Perú, cuya distribución conocida estaba restringida a las vertientes occidentales de La Libertad, Áncash y Lima. En base a expediciones botánicas por las estribaciones andinas de Ica, en este trabajo reportamos nuevas localidades con pequeñas poblaciones, lo que amplía en más de 260 km al sur la distribución conocida de A. pachypus. Además, en base a 42 registros georreferenciados, se amplía la información sobre sus localidades, poblaciones, distribución potencial, hábitats, amenazas y estado de conservación. El modelo de distribución potencial mostró altos niveles predictivos o de idoneidad con valores de AUC = 0.96 en base a siete variables climáticas, siendo Bio17, Bio2 y Bio7 las variables con mayor contribución; mostrando a Lambayeque, La Libertad, Áncash, Lima, Ica y Huancavelica los departamentos con mayores valores de idoneidad. Las poblaciones con mayor concentración de individuos, pero que a su vez se encuentran seriamente perturbadas por actividades antropogénicas, son las de los valles del río Chillón (Santa Rosa de Quives, Canta) y Rímac (Santa Eulalia, Huarochirí) en Lima. Asimismo, se estima que cerca del 70% de las poblaciones de A. pachypus se encuentran amenazadas por derechos mineros, extracción de hidrocarburos, sobrepastoreo y expansión urbana o agrícola, incrementando la fragmentación de sus hábitats, por lo que se propone categorizar a este cactus endémico como En Peligro (EN).

Abstract Austrocylindropuntia pachypus (K.Schum.) Backeb. is an endemic cactus of Peru, whose known distribution was restricted to the western slopes of La Libertad, Áncash, and Lima. Based on botanical expeditions along the Andean foothills of Ica, this study reports new localities with small populations, thereby extending the known distribution of A. pachypus by over 260 km to the south. Additionally, based on 42 georeferenced records, information on its localities, populations, potential distribution, habitats, threats, and conservation status is expanded. The potential distribution model exhibited high predictive or suitability levels with AUC values of 0.96 based on seven climatic variables, with Bio17, Bio2, and Bio7 being the most contributory variables; Lambayeque, La Libertad, Áncash, Lima, Ica, and Huancavelica demonstrated the highest suitability values. Populations with the highest concentration of individuals, yet significantly disturbed by anthropogenic activities, are those in the valleys of the Chillón River (Santa Rosa de Quives, Canta) and Rímac River (Santa Eulalia, Huarochirí) in Lima. Furthermore, it is estimated that approximately 70% of A. pachypus populations are threatened by mining rights, hydrocarbon extraction, overgrazing, and urban or agricultural expansion, exacerbating habitat fragmentation. Hence, it is proposed to categorize this endemic cactus as Endangered (EN).

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BACKGROUND: Ovarian tissue cryopreservation has been proven to preserve fertility against gonadotoxic treatments. It has not been clear how this procedure would perform if planned for slowing ovarian aging. OBJECTIVE: This study aimed to determine the feasibility of cryopreserving ovarian tissue to extend reproductive life span and delay menopause by autotransplantation near menopause. STUDY DESIGN: Based on the existing biological data on follicle loss rates, a stochastic model of primordial follicle wastage was developed to determine the years of delay in menopause (denoted by D) by ovarian tissue cryopreservation and transplantation near menopause. Our model accounted for (1) age at ovarian tissue harvest (21-40 years), (2) the amount of ovarian cortex harvested, (3) transplantation of harvested tissues in single vs multiple procedures (fractionation), and (4) posttransplant follicle survival (40% [conservative] vs 80% [improved] vs 100% [ideal or hypothetical]). RESULTS: Our model predicted that, for most women aged <40 years, ovarian tissue cryopreservation and transplantation would result in a significant delay in menopause. The advantage is greater if the follicle loss after transplant can be minimized. As an example, the delay in menopause (D) for a woman with a median ovarian reserve who cryopreserves 25% of her ovarian cortex at the age of 25 years and for whom 40% of follicles survive after transplantation would be approximately 11.8 years, but this extends to 15.5 years if the survival is 80%. As another novel finding, spreading the same amount of tissue to repetitive transplants significantly extends the benefit. For example, for the same 25-year-old woman with a median ovarian reserve, 25% cortex removal, and 40% follicle survival, fractionating the transplants to 3 or 6 procedures would result in the corresponding delay in menopause (D) of 23 or 31 years. The same conditions (3 or 6 procedures) would delay menopause as much as 47 years if posttransplant follicle survival is improved to 80% with modern approaches. An interactive Web tool was created to test all variables and the feasibility of ovarian tissue freezing and transplantation to delay ovarian aging (here). CONCLUSION: Our model predicts that with harvesting at earlier adult ages and better transplant techniques, a significant menopause postponement and, potentially, fertile life span extension can be achieved by ovarian tissue cryopreservation and transplantation in healthy women.

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The aim of the present study was to summarize the effectiveness of amino acid supplementation on muscle strength, muscle volume, and functional capacity in patients undergoing total knee arthroplasty. For this, in November 2022, a search was carried out in the PubMed, Cochrane Library, and EMBASE databases, identifying a total of 2182 documents, of which only 4 were included in the present review. The included studies had 148 participants (47 men and 101 women), with a minimum age of 53 and a maximum of 92 years, and supplementation times of 13 to 30 days (1 to 3 times a day). For the results, in relation to muscle performance, when comparing the control and experimental groups, greater muscle atrophy was observed in the pre- and post-moments of the control group, in relation to the experimental group. In addition, studies suggest a good tendency for muscle mass gain, and improvement in the functional capacities of patients who used supplementation. Therefore, the use of amino acids after TKA surgery reduces muscle atrophy, which preserves muscle mass and leads to better performance in tests of strength and functional capacity, when compared to the use of a placebo.

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PURPOSE: Based on the tripod concept of load distribution, our study aimed to evaluate whether a slight extension of first metatarsal (M1) that may occur after the Lapidus procedure (LP) could alter the radiographic measurements of the hindfoot and influence clinical and functional outcomes. METHODS: Twenty-five patients (27 feet) were reviewed. Hindfoot radiographic analysis was based on seven measurements. Clinical and functional outcomes were evaluated with self-reported questionnaires. Transfer metatarsalgia was also assessed. Correlation analysis was performed according to variations of the studied variables. RESULTS: The average extension of the M1 was 4.26 degrees (p < 0.001). None of the hindfoot radiographic measurements changed significantly (p = 0.13, p = 0.50, p = 0.19, p = 0.70, p = 0.11, p = 0.36, p = 0.83). Patients improved on most questionnaires (p < 0.001). None presented transfer metatarsalgia. No correlation between M1 extension and clinical and functional outcomes was found. CONCLUSION: Possibly there is a tolerance of M1 extension in which it does not alter the radiographic measurements of the hindfoot, overload the lesser metatarsals, or compromise clinical and functional outcomes.

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BACKGROUND: Achieving an aesthetically pleasant tip rotation is paramount in rhinoplasty, and these results should be long-lasting. However, even powerful structural techniques such as septal extension grafts can lose rotation over time, as most support depends on the attachment of the graft to the septal cartilage. METHODS: We describe a simple suture technique to strengthen tip support in rhinoplasty, by suspending it to the cartilaginous dorsum, providing additional support to the tip against forces, such as gravity, scar contraction and muscle tension. CONCLUSIONS: Combining traditional techniques with suspension sutures can improve intraoperative results and could enhance long-term tip stability.

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A specimen of tripletail Lobotes surinamensis (total length: 402 mm, total mass: 1262 g) was caught in the shallow waters of the inner Bristol Channel on September 2, 2019, with this only the second known capture of this species from the British Isles. Given the cosmopolitan distribution of this species, the potential origin of this specimen is uncertain.

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Abstract Objective We aimed to assess the significance of rENE and creat a predictive tool (nomogram) for estimating Overall Survival (OS) in locoregionally advanced Nasopharyngeal Carcinoma (NPC) patients with Lymph Node Metastasis (LNM) based on their clinical characteristics and Radiologic Extranodal Extension (rENE). Methods Five hundred and sixty-nine NPC patients with LNM were randomly divided into training and validation groups. Significant factors were identified using univariate and multivariate analyses in the training cohort. Then, the nomogram based on the screening results was established to predict the Overall Survival (OS). Calibration curves and the Concordance index (C-index) gauged predictive accuracy and discrimination. Receiver Operating Characteristic (ROC) analysis assessed risk stratification, and clinical utility was measured using Decision Curve Analysis (DCA). The nomogram's performance was validated for discrimination and calibration in an independent validation cohort. Results A total of 360 (63.2%) patients were present with radiologic extranodal extension at initial diagnosis. Patients with rENE had significantly lower OS than other patients. Multivariate analysis identified the five factors, including rENE, for the nomogram model. The C-index was 0.75 (0.71-0.78) in the training cohort and 0.76 (0.69-0.83) in the validation cohort. Notably, the nomogram outperformed the 8th TNM staging system, as evident from the higher AUC values (0.77 vs. 0.60 for 2 year and 0.75 vs. 0.65 for 3 year) and well-calibrated calibration curves. Decision curve analysis indicated improved Net Benefit (NB) with the nomogram for predicting OS. The log-rank test confirmed significant survival distinctions between risk groups in both training and validation cohorts. Conclusions We demonstrated the prognostic value of rENE in nasopharyngeal carcinoma and developed a nomogram based on rENE and other factors to provide individual prediction of OS for locoregionally advanced nasopharyngeal carcinoma with lymph node metastasis. Level of evidence: III.

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Este estudo objetivou avaliar aspectos que exercem influência sobre a contagem bacteriana total (CBT) e a contagem de células somáticas (CCS) do leite e avaliar a adequação das amostras do produto à Instrução Normativa nº 76, de 26 de novembro de 2018, do Ministério da Agricultura e Pecuária do Brasil (IN 76). A pesquisa foi realizada em propriedades rurais da microrregião de Birigui, São Paulo, Brasil, e se baseou em coleta de dados, por entrevista estruturada, e coletas de leite nas propriedades. Foi realizada amostragem por conveniência, sendo escolhidos 15 produtores de cada estrato (de acordo com a produção diária de leite: pequeno - até 100 L; médio - 101 a 300 L; grande - mais de 300 L), totalizando 45 produtores de leite. Participaram da pesquisa somente propriedades com base da alimentação volumosa em sistema de pastejo ou em semiconfinamento. Para avaliar a influência de diferentes fatores sobre a contagem bacteriana total (CBT) e a contagem de células somáticas (CCS), separadamente, realizou-se regressão multivariada. Ainda, foi determinado o coeficiente de correlação entre variáveis desta pesquisa. As variáveis resposta foram transformadas em logaritmo para normalização dos dados. Foi feita comparação entre os resultados da pesquisa e os parâmetros da IN 76 para verificar o cumprimento das normas pelos produtores. Foram encontrados valores médios de 6.986.977,818.961.790,7 UFC/mL para CBT e de 608.911,1 ± 414.802,9 CS/mL para CCS. A utilização de tanque de resfriamento individual mostrou-se favorável à baixa CBT, em comparação com não uso de tanque ou uso de tanque comunitário, conforme o esperado, pois quanto mais tempo leva para resfriar o leite, maior é a proliferação de bactérias no produto. Foi verificado que o leite de produtores que realizam o California Mastitis Test (CMT) com maior frequência apresentou CCS mais elevada, o que não era esperado. As análises físico-químicas médias foram densidade 1,031 g/mL a 15°C, índice crioscópico -0,538 °H, teor de proteína 3,58%, teor de gordura 4,06%, extrato seco total 12,75%, extrato seco desengordurado 8,69%, acidez titulável 16,2 °D e estabilidade ao álcool (Alizarol 72%) 100%. Em 13,3% (6/45) das amostras foi detectada presença de antibióticos. Considerando a IN 76, o leite de somente 8,9% (4/45) dos produtores apresentou-se adequado simultaneamente para todos os parâmetros analisados (CBT, CCS, densidade, índice crioscópico, proteína, gordura, extrato seco total, extrato seco desengordurado, acidez titulável, estabilidade ao alizarol e pesquisa de antibióticos). A utilização de tanque de resfriamento individual e a realização de CMT favoreceram menor CBT e maior CCS, respectivamente.

This study aimed to evaluate aspects that exerts influence on the total bacterial count (TBC) and somatic cell count (SCC) of milk and evaluate the conformity of the samples to the Normative Instruction no. 76, from November 26, 2018, of the Brazilian Agriculture and Livestock Ministry (NI 76). The research was done in farms around Birigui micro-region, São Paulo State, Brazil, and was based on data collection obtained by structured interviews and milk collection in the farms. Convenience sampling was carried out from 15 producers of each stratum (according to daily milk production: small - up to 100 L; medium - 101 to 300 L; large - more than 300 L), totalizing 45 milk producers. Only farms with grazing or semi-feedlot system for roughage feeding base were included. To evaluate the influence of different factors on Total Bacterial Count (TBC) and Somatic Cell Count (SCC), separately, a multivariate regression was done. Moreover, the correlation coefficient among variables was determined. The response variables were transformed into logarithms for the normalization of the data. A comparison between results and NI 76 parameters was done to verify the standard compliance by producers. Mean TBC was 6.986.977,8 ± 18.961.790,7 CFU/mL and mean SCC was 608.911,1414.802,9 cells/mL. The use of individual cooler tank was favorable to lower TBC, compared with the non-use of the tank or with the use of the communitarian tank, as expected, since the longer it takes to cool the milk, the higher the proliferation of bacteria in the product. It was verified that milk from farmers that more frequently perform California Mastitis Test (CMT) showed higher SCC, which was not expected. The average physicochemical analyzes were density 1.031 g/mL at 15°C, cryoscopic index -0.538 °H, protein content 3.58%, fat content 4.06%, total dry extract 12.75%, dry extract defatted 8.69%, titratable acidity 16.2 °D and alcohol stability (Alizarol 72%) 100%. The presence of antibiotics was detected in 13.3% (6/45) of the samples. Considering NI 76, milk from only 8.9% (4/45) farmers were proper simultaneously for all the parameters analyzed (TBC, SCC, density, cryoscopic index, protein, fat, total dry extract, defatted dry extract, titratable acidity, alizarol stability and antibiotics). The use of individual cooling tank and the CMT performance support lower TBC and higher SCC respectively.

Este estudio tuvo como objetivo evaluar los aspectos que influyen en el contaje bacteriano total (CBT) y el contaje de células somáticas (CCS) de la leche y evaluar la adecuación de las muestras del producto a la Instrucción Normativa nº 76, de 26 de noviembre de 2018, del Ministerio de Agricultura y Ganadería en Brasil (IN 76). La investigación se llevó a cabo en propiedades rurales en la microrregión de Birigui, São Paulo, Brasil, y se basó en la recolección de datos, a través de entrevistas estructuradas, y colectas de leche en las propiedades. Se realizó un muestreo por conveniencia, escogiendo 15 productores de cada estrato (de acuerdo con la producción diaria de leche: pequeño - hasta 100 L; medio - 101 hasta 300 L; grande ­ más de 300 L), totalizando 45 productores de leche. Participaron de la investigación únicamente propiedades basadas en alimentación voluminosa en sistema de pastoreo o, a lo sumo, en semiconfinamiento. Para evaluar la influencia de diferentes factores sobre el contaje bacteriano total (CBT) y el contaje de células somáticas (CCS), por separado, se realizó una regresión multivariada. Asimismo, se determinó el coeficiente de correlación entre las variables de esta investigación. Las variables de respuesta se transformaron en logaritmos para la normalización de datos. Se realizó una comparación entre los resultados de la investigación y los parámetros de la IN 76 para verificar el cumplimiento de las normas por parte de los productores. Se encontraron valores medios de 6.986.977,818.961.790,7 UFC/mL para CBT y de 608.911,1 +414.802,9 CS/mL para CCS. El uso de un tanque de enfriamiento individual se ha mostrado favorable a la baja CBT, en comparación con no usar un tanque o usar un tanque comunitario, conforme lo esperado, ya que cuanto más se tarda en enfriar la leche, mayor es la proliferación de bacterias en el producto. Se verificó que la leche de los productores que realizan el California Mastitis Test (CMT) con mayor frecuencia presentó CCS más alto, lo cual no se esperaba. Los análisis fisicoquímicos promedio fueron densidad 1,031 g/mL a 15°C, índice crioscópico -0,538 °H, contenido de proteína 3,58%, contenido de grasa 4,06%, extracto seco total 12,75%, extracto seco desgrasado 8,69%, acidez titulable 16,2°D y estabilidad del alcohol (Alizarol 72%) 100%. En el 13,3% (6/45) de las muestras se detectó la presencia de antibióticos. Considerando la IN 76, la leche de solo el 8,9% (4/45) de los productores se presentó adecuado simultáneamente para todos los parámetros analizados (CBT, CCS, densidad, índice crioscópico, proteína, grasa, extracto seco total, extracto seco desgrasado, acidez titulable, estabilidad al alizarol e investigación de antibióticos). El uso de un tanque de enfriamiento individual y la realización de CMT favorecieron un CBT más bajo y un CCS más alto respectivamente.

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OBJECTIVE: We aimed to assess the significance of rENE and creat a predictive tool (nomogram) for estimating Overall Survival (OS) in locoregionally advanced Nasopharyngeal Carcinoma (NPC) patients with Lymph Node Metastasis (LNM) based on their clinical characteristics and Radiologic Extranodal Extension (rENE). METHODS: Five hundred and sixty-nine NPC patients with LNM were randomly divided into training and validation groups. Significant factors were identified using univariate and multivariate analyses in the training cohort. Then, the nomogram based on the screening results was established to predict the Overall Survival (OS). Calibration curves and the Concordance index (C-index) gauged predictive accuracy and discrimination. Receiver Operating Characteristic (ROC) analysis assessed risk stratification, and clinical utility was measured using Decision Curve Analysis (DCA). The nomogram's performance was validated for discrimination and calibration in an independent validation cohort. RESULTS: A total of 360 (63.2%) patients were present with radiologic extranodal extension at initial diagnosis. Patients with rENE had significantly lower OS than other patients. Multivariate analysis identified the five factors, including rENE, for the nomogram model. The C-index was 0.75 (0.71-0.78) in the training cohort and 0.76 (0.69-0.83) in the validation cohort. Notably, the nomogram outperformed the 8th TNM staging system, as evident from the higher AUC values (0.77 vs. 0.60 for 2year and 0.75 vs. 0.65 for 3year) and well-calibrated calibration curves. Decision curve analysis indicated improved Net Benefit (NB) with the nomogram for predicting OS. The log-rank test confirmed significant survival distinctions between risk groups in both training and validation cohorts. CONCLUSIONS: We demonstrated the prognostic value of rENE in nasopharyngeal carcinoma and developed a nomogram based on rENE and other factors to provide individual prediction of OS for locoregionally advanced nasopharyngeal carcinoma with lymph node metastasis. LEVEL OF EVIDENCE: III.

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Resumen La perspectiva de tiempo futuro (PTF) es un proceso multidimensional de tipo cognitivo motivacional que influye en las decisiones de los adolescentes sobre su futuro. Este estudio pretendió analizar la relación entre la PTF y las variables sociodemográficas edad, grado educativo, género y ciudad de residencia, en una muestra de 982 estudiantes entre los 12 y 18 años de edad cronológica, de nivel socioeconómico medio bajo, que cursan el ciclo de educación media, en cinco colegios de dos ciudades de Colombia. A través de un estudio empírico analítico de corte transversal, con un diseño correlacional, se midieron las dimensiones actitud y orientación temporal y la extensión temporal a través del cuestionario los jóvenes y el futuro. Los resultados muestran que los estudiantes de grado undécimo, de género femenino, residentes en la ciudad de Acacias, presentaron las medias más altas en la dimensión de actitud y orientación temporal. Se evidenciaron correlaciones significativas entre las dimensiones actitud y orientación temporal y extensión temporal con las variables sociodemográficas estudiadas. Esto confirma que los adolescentes de ambos géneros presentan interés en la planeación del futuro, la que es mayor según el grado educativo, y difiere dependiendo del contexto donde viven.

Abstract The future perspective time is a cognitive motivational multidimensional process which influences the decisions of the teenagers about their future. This study pretended to analyze the relation between PTF and sociodemographic variables age, education level, gender and the city of residence, in a sample of 982 students, with ages between 12 and 18 years old, with a lower middle socioeconomic level, belonging to five schools in two cities in Colombia. Through an empirical analytical cross-sectional study, with correlational design, applied the questionnaire "Young people and the future" to measure the dimensions of attitude and temporal orientation and temporal extension. The results showed that 11th grade students, female gender, living in Acacías city, present the highest average in attitude and temporarily orientation dimensions. There were significant evidenced correlations between attitude, temporarily orientation, and temporal extensions dimensions with the sociodemographics variables studies. Which confirms that the teenagers of both genders show interested in the future planning, which is higher based on level education and depends of the context where they live.

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Tomando como insumo la etnografía realizada con objeto de la escritura de la tesis, pero realizando el recorte que demanda un artículo, me centraré en reconstruir tres puntos que dan cuenta de aspectos vinculados a la dimensión comunicativa, y que resultan ejemplos paradigmáticos de dimensiones constitutivas del vínculo entre cooperativistas y acompañantes, los cuales nos permiten advertir las huellas institucionales de la cárcel y la universidad en el modo de trabajo conjunto con la intención de advertir cómo se articulan, potencian o complejizan la relación en el marco de la experiencia extensionista. Asimismo, en las reuniones de producción los saberes jerarquizados se invertían en relación a los días de reunión general, y también el rol de lxs sujetxs. Lxs cooperativistas detentaban cierta autoridad en estos días, marcándose una asimetría en torno al saber que se construía de modo situacional y contextual - los días de producción primaban los saberes en torno a la tela, a diferencia de los días de reunión general, en los que primaba la palabra-, lo cual nos permite entender que los conocimientos que se ponen a dialogar deben ser comprendidos en vínculo con sus condiciones de enunciación y según el contexto. Son las diferencias las que se constituyen en punto de contacto y que deben hacerse inteligibles para el diálogo y trabajo con otrxs, las cuales pueden ser entendidas como saberes prácticos que se entrelazan con otros saberes en la experiencia, o en el "mientras tanto" se buscan otros diálogos de saberes conceptuales.

Tomando como aporte a etnografia realizada para a redação da tese, mas fazendo o recorte que um artigo exige, vou me concentrar em reconstruir três pontos que dão conta de aspectos relacionados à dimensão comunicativa, e que são exemplos paradigmáticos de dimensões constitutivas do vínculo entre cooperados e acompanhantes, que permitem perceber os traços institucionais da prisão e da universidade no modo de trabalho conjunto com a intenção de perceber como a relação se articula, se fortalece ou se complexifica no âmbito da experiência de extensão. Da mesma forma, nas reuniões de produção, os saberes hierarquizados se inverteram em relação aos dias da assembléia geral, e também o papel dos sujeitos. Os cooperados detinham certa autoridade nesses dias, marcando uma assimetria em torno do conhecimento que se construía de forma situacional e contextual - os dias de produção eram dominados pelo conhecimento sobre o tecido, ao contrário dos dias da reunião geral, quando a palavra prevalecia -, o que nos permite compreender que os saberes que se colocam em diálogo devem ser entendidos em conexão com suas condições de enunciação e de acordo com o contexto. São as diferenças que constituem o ponto de contato e que devem ser tornadas inteligíveis para o diálogo e o trabalho com os outros, que podem ser entendidas como saberes práticos que se entrelaçam com outros saberes na experiência, ou no "enquanto" buscam outros diálogos de conhecimento conceitual.

Taking as input the ethnography carried out for the purpose of writing the thesis, but making the cut that an article demands, I will focus on reconstructing three points that account for aspects related to the communicative dimension, and that are paradigmatic examples of dimensions constitutive of the link between cooperative members and companions, which allow us to notice the institutional traces of the prison and the university in the way of joint work with the intention of noticing how the relationship is articulated, strengthened or made more complex within the framework of the extension experience. Likewise, in the production meetings, the hierarchical knowledge was inverted in relation to the days of the general meeting, and also the role of the subjects. The cooperative members held a certain authority in these days, marking an asymmetry around the knowledge that was built in a situational and contextual way - the days of production prevailed the knowledge around the fabric, unlike the days of general meeting, in which the word prevailed-, which allows us to understand that the knowledge that is put into dialogue must be understood in connection with its conditions of enunciation and according to the context. It is the differences that constitute the point of contact and that must be made intelligible for dialogue and work with others, which can be understood as practical knowledge that is intertwined with other knowledge in experience, or in the "meanwhile" They look for other dialogues of conceptual knowledge.

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Introduction Correction of caudal septal deviations has always been a challenging subject in septorhinoplasty. The septum batten extension graft (SBEG) is a new graft that has potential properties in rhinoplasty. However, few reports have evaluated the surgical outcomes of this technique. Objective The purpose of this study was to evaluate the effectiveness of SBEG in correcting caudal septal deviation. Methods This cross-sectional study was conducted on patients with caudal septal deviation undergoing septorhinoplasty using SBEG at 2 different hospitals in 2019. We then retrospectively reviewed medical records and photographs of 50 patients at the preoperative period, as well as at 1-month, and 12-month postoperatively. Gross changes in nasolabial angle, columellar show, nasal tip projection, and dorsal nasal deviation were evaluated by a photographic analysis method, and nasal obstruction was assessed by patient satisfaction with breathing. Results There was a significant difference between the mean nasolabial angle and columellar show at 1 and 12-months postoperatively, compared with the previous values ( p < 0.0001). The nasolabial angles were in a favorable position with an increase of 12 to 15 degrees compared with the preoperative state. The columellar show also improved by an average of 1.2 mm and was in good condition. The postoperative dorsal nasal deviation was significantly reduced, and projection was significantly increased (3.521 ± 0.087 mm vs. 0.719 ± 0.028; p < 0.0001; p < 0.001). Moreover, this method had a significant favorable effect on nasal obstruction ( p = 0.049). Conclusion Our results showed that septorhinoplasty using SBEG is useful for correcting caudal septal deviation, with favorable surgical outcomes, and it has responded well to all five aforementioned criteria.

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O Projeto de Extensão é uma ação proveniente da Extensão Universitária que promove a integração entre a universidade, local onde se disponibiliza os conhecimentos acadêmicos e científicos, e a sociedade que contribui com os seus saberes. Diante disso, a Faculdade de Odontologia da Universidade Federal Fluminense em Niterói conta com os serviços do Técnico em Saúde Bucal, entretanto não possui Projeto de Extensão dedicado a esses profissionais. Logo, o objetivo deste artigo foi realizar um estudo de revisão da literatura sobre a importância do Projeto de Extensão orientado para a formação profissional do Técnico em Saúde Bucal, com vistas a fortalecer as relações entre a Faculdade de Odontologia da Universidade Federal Fluminense e a sociedade. Para tanto, foi realizada uma revisão narrativa de literatura com incursão nos sítios eletrônicos do Google Acadêmico e Biblioteca Digital de Teses e Dissertações, além do levantamento de estudos que evidenciassem a formação profissional por meio de Projeto de Extensão para a integração social. Os resultados da revisão mostraram a falta de Projetos de Extensão voltados ao Técnico em Saúde Bucal. Assim, conclui-se ser de extrema relevância a criação de um Projeto de Extensão na Faculdade de Odontologia da Universidade Federal Fluminense em Niterói.

Extension programs consist in university extension actions that aim to promote the integration between university, which is the place where academic and scientific knowledge is provided as well as society which contributes with its own knowledge. In this sense, the Dental School from Universidade Federal Fluminense, in Niterói, has access to the services offered by the Technical Course in Oral Health; however, there is no extension program dedicated to undergraduate new professionals in this area. Thus, this paper aims to show the importance of creating an extension program directed to the professional improvement of Oral Health technicians in order to strengthen the relationship between Dental School and society. In order to achieve this objective, a literature narrative review was made with an incursion in Google Scholar and the Digital Library of Theses and Dissertations. In addition to that, a survey was made on studies that highlighted professional qualification through extension programs in order to conquer social integration.

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The purpose of this study was to examine the effects of static stretching (SS) of agonists and antagonists between sets on the total training volume (TTV) performed across multiple sets for the leg extension exercise. Twelve male subjects with experience in resistance training (RT) participated in this study. Subjects performed 10 repetition maximum (10RM) test and retest trials for the leg extension exercise. Four different protocols were randomly applied as follows: quadriceps stretching (AG); hamstrings stretching (AN); quadriceps and hamstrings stretching (AGN); and traditional control without stretching (TR). Significant differences (p≤0.05) were observed in the TTV between the AG (4855.42 ± 1279.38 kg) and AN (6002.08 ± 1805.18 kg), AGN (5977.50 ± 1778.49 kg), and TR (6206.04 ± 1796.15 kg) protocols. These results suggest that when practicing inter-set SS, it should be done for antagonist rather than agonist muscles when the intent is to maximize TTV.

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Objetivo: Descrever a experiência do uso de redes sociais como instrumentos em ações de educação em saúde, promoção e prevenção durante a pandemia de COVID-19. Metodologia: Trata-se de um estudo descritivo realizado no projeto de extensão "Sustentabilidade do PET-SAÚDE Interprofissionalidade" dando continuidade às ações interventivas do curso de Odontologia da Universidade Federal de Juiz de Fora, campus Governador Valadares-MG, que realizou ações de promoção de saúde em atenção primária entre abril de 2020 e junho de 2021. O projeto teve a participação de 4 discentes e 2 docentes do curso de Odontologia da UFJF/GV com parceria da Secretaria Municipal de Saúde de Governador Valadares-MG. As ações foram desenvolvidas pelos discentes, os quais dividiram o processo em nove etapas. As atividades foram veiculadas pelas redes sociais sob o título "Vida Saudável e Autocuidado: PET-Saúde Interprofissionalidade UFJF/GV". Resultados: Foram realizadas 37 postagens com abordagem de 33 assuntos, alguns temas foram divididos entre partes 1 e 2, para melhor enfoque das comunicações. Obtivemos na rede social Instagram um total de 175 seguidores que acompanhavam as publicações feitas semanalmente. Os materiais produzidos também foram postados em formato de vídeo no Youtube e compartilhados no Facebook, visando aumentar a interação com os seguidores, somando 642 visualizações. As postagens atingiram o total de 1510 curtidas nas páginas do projeto. Conclusão: As redes sociais demostraram ser inovadoras na disseminação de informação para a população, alcançando a troca de saberes, no processo ensino-aprendizagem em tempos de pandemia, possibilitando o desenvolvimento de competências necessárias para a formação profissional.(AU)

Objective: To describe the experience of using social networks as instruments in health education, promotion and prevention actions during the COVID-19 pandemic. Methodology: This is a descriptive study carried out in the extension project "Sustainability of PET-SAÚDE Interprofissionalidade", continuing the interventional actions of the Dentistry course at the Federal University of Juiz de Fora, Governador Valadares-MG campus, which carried out actions to promote health in primary care between April 2020 and June 2021. The project had the participation of 4 students and 2 professors from the UFJF/GV Dentistry course in partnership with the Municipal Health Department of Governador Valadares-MG. The actions were developed by the students, who divided the process into nine stages. The activities were broadcast on social networks under the title "Healthy Life and Self-Care: PET-Saúde Interprofissionalidade UFJF/GV". Results: 37 posts were made covering 33 subjects, some themes were divided into parts 1 and 2, for a better focus on communications. We obtained a total of 175 followers on the Instagram social network that followed the publications made weekly. The materials produced were also posted in video format on Youtube and shared on Facebook, aiming to increase interaction with followers, totaling 642 views. Posts reached a total of 1510 likes on the project pages. Conclusion: Social networks proved to be innovative in disseminating information to the population, achieving the exchange of knowledge in the teaching-learning process in times of pandemic, enabling the development of skills necessary for professional training. (AU)

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